NAME: _________________________________ AGE:_________
GRADE AND SECTION:_____________________ SEX:_________
ATTENDANCE 4 3 2 1
1.1 I lose sleep due to overthinking.
1.2 I feel tired going to school because of exhaustion.
1.3 I skip classes because I want to be alone.
1.4 I am often absent in school because I don’t like to interact with people.
1.5 I slack in class due to lack of sleep.
ACADEMIC PERFORMANCE
2.1 I feel like contemplating on the corners rather than doing my projects.
2.2 I spend more on my alone time rather than participating in a group activity/presentation.
2.3 I am not in the mood to do my studies for my oral examination.
2.4 I prefer to just sit than doing my assigned group presentation.
2.5 My grades in performance tasks are low due to inadequate time doing it because I spend all of
my time to be alone.
CLASS INTERACTION
3.1 I am not in the mood to listen to my classes.
3.2 I don’t like to talk with my classmates or my friends.
3.3 I don’t like to interact with my classmates or friends.
3.4 I get cold to everyone whenever they try to talk to me and ask me something about myself.
3.5 I don’t like to socialize inside and outside the classroom.
4 - STRONGLY AGREE
3- AGREE
2- DISAGREE
1- STRONGLY DISAGREE
______________________________________________________________________________________________________
NAME: _________________________________ AGE:_________
GRADE AND SECTION:_____________________ SEX:_________
ATTENDANCE 4 3 2 1
1.1 I lose sleep due to overthinking.
1.2 I feel tired going to school because of exhaustion.
1.3 I skip classes because I want to be alone.
1.4 I am often absent in school because I don’t like to interact with people.
1.5 I slack in class due to lack of sleep.
ACADEMIC PERFORMANCE
2.1 I feel like contemplating on the corners rather than doing my projects.
2.2 I spend more on my alone time rather than participating in a group activity/presentation.
2.3 I am not in the mood to do my studies for my oral examination.
2.4 I prefer to just sit than doing my assigned group presentation.
2.5 My grades in performance tasks are low due to inadequate time doing it because I spend all of
my time to be alone.
CLASS INTERACTION
3.1 I am not in the mood to listen to my classes.
3.2 I don’t like to talk with my classmates or my friends.
3.3 I don’t like to interact with my classmates or friends.
3.4 I get cold to everyone whenever they try to talk to me and ask me something about myself.
3.5 I don’t like to socialize inside and outside the classroom.
4 - STRONGLY AGREE
3- AGREE
2- DISAGREE
1- STRONGLY DISAGREE